Library

The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: "When the Earth Qi of the year is insufficient, Wind Qi will prevail excessively... The people suffer from undigested diarrhea, Huoluan (cholera-like acute gastroenteritis), heavy body sensation, abdominal pain, and spasms of the sinews and bones."

Commentary: This refers to the insufficiency of the Earth transport, leading to an excess of Wood Qi. Wood overacts on Earth causing disease. One should carefully study the original text.

The *Huangdi Neijing* states: "A deep, hidden pulse indicates Huoluan."

The *Shanghan Lun* (Treatise on Cold Damage) states: "Disease presenting with vomiting and diarrhea is named Huoluan. Or accompanied by fever, headache, body pain, and aversion to cold, with vomiting and diarrhea; or initially self-induced vomiting and purging, followed by cessation of diarrhea but recurrence of fever. These are all Huoluan syndromes."

The *Shanghan Lun* further states: "In cold damage, if the pulse is faint and choppy, it was originally Huoluan. Now it is cold damage. After four or five days, when it transmits to the Yin meridians, diarrhea must occur. If there was originally vomiting and diarrhea, it is difficult to treat."

The *Baoming Ji* (Collection for Preserving Life) records: "Cold damage transforming into Huoluan with muscle cramps, fever, and a long pulse is a disease of the Yangming channel itself. It arises because the Spleen and Stomach are affected by damp-heat, causing Qi stagnation in the Middle Jiao. Or it results from consuming frozen drinks, injuring oneself with cold water, or contracting dampness. When cold and heat are unbalanced, Water and Fire interfere, Yin and Yang contend, Upper and Lower separate, and Ying and Wei cannot maintain each other, thus causing muscle cramps and spasms, and chaotic meridian circulation. Acute heat causing vomiting and diarrhea is primarily governed by the Qi of the Middle Jiao Stomach."

Respectfully noted: Transformation of cold damage into Huoluan is rare. It mostly occurs in summer and autumn when the weather is hot, the pores are open, and one contracts wind-dampness Qi. There are often differences in Yin-Yang deficiency and excess. A floating and surging pulse is curable; a faint and slow pulse with shortness of breath and inability to speak is difficult to treat.

Chen Wuyue stated: "Huoluan involves sudden heart and abdominal pain, vomiting, diarrhea, aversion to cold, high fever, headache, and dizziness. If heart pain precedes, vomiting comes first; if abdominal pain precedes, diarrhea comes first. If both heart and abdomen hurt, vomiting and diarrhea occur simultaneously. Severe cases involve muscle cramps entering the abdomen, leading to death. No evil syndrome of Huoluan exceeds this. It is due to the reversal of Yin and Yang, interference between clear and turbid Qi, sudden rising of Yang Qi, and sudden falling of Yin Qi. Yin and Yang become obstructed and blocked, rushing up and down. Treatment should only use warming methods, and one must carefully distinguish the Three Causes to regulate."

External causes: Caused by various winds, there is aversion to wind and sweating; caused by cold damage, there is aversion to cold and no sweating; caused by stomach dampness, there is heaviness; caused by summerheat, there is heat and vexation. Internal causes: Caused by the Nine Qi, depression and accumulation of phlegm-fluids, food stagnation and obstruction lead to fullness and stuffiness. Depending on the victory and revenge cycles, vomiting and diarrhea inevitably occur. Or after overeating rich foods, indulging in milk, cheese, iced meat, cold beverages, and fine wine, the Stomach becomes distended, and the Spleen stagnates. Internal depression erupts, resulting in vomiting and diarrhea. This belongs to the Non-internal and Non-external causes.

Commentary: This thoroughly covers the Three Causes of Huoluan. However, the formulated prescriptions do not exhaust all variations. Students should deduce and explore accordingly.